Health At Every Size: The Surprising Truth About Your Weight (29 page)

BOOK: Health At Every Size: The Surprising Truth About Your Weight

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We were flooded with women begging to be admitted to the study. One after another, they told us their stories of endless attempts to lose weight, desperate to be enrolled in a scientific study at a respected university. When I told one forty-six-year-old woman that she couldn’t participate because she was too old, she broke down in tears, telling me we were her last hope. Her physician, nutritionist, and social worker called me the next day to pressure me into bending the rules. (I still couldn’t let her in!)

Eighty-two women who met the initial criteria attended an informational meeting, where we explained the program and answered questions. Every one signed the consent form.

We then weighed and measured them to ensure their size met the medical definition of obese (BMI greater than 30) but didn’t surpass the arbitrary upper limit of a BMI of 45. The women also completed questionnaires about their health status.

When we checked identification, we were surprised to find that several women had lied about their age! There were other signs of these women’s desperation: One participant was willing to undergo a two-hour commute each way to participate. Their stories of how their weight affected their lives pained me. One woman told me her boss was threatening to fire her from her job as a receptionist if she didn’t lose weight. Another was about to lose her job in a fitness center, while one woman’s husband was threatening her with divorce if she didn’t lose weight.

I heard story after story about how painful it was to live in a large body. And yet every woman had tried numerous diet and exercise programs. By now, they felt beaten up by the process and were plagued by an overwhelming sense of failure.

The seventy-eight women who met our criteria were enrolled in the study, and a computer randomly assigned them to either the HAES group or the conventional diet program group.

Each group was then broken into four smaller sections of nine or ten women who met weekly for six months, providing individualized attention and small group support. During the second six months of the program, which we called the follow-up period, the groups met monthly.

The women in the diet group received conventional messages about dieting and attitudes toward their bodies. They learned to moderately restrict their fat and calorie intake, and were encouraged to monitor their diet with a food diary and to weigh themselves weekly. They were also encouraged to walk or participate in other exercise. They learned how to count fat grams, understand food labels, and shop for food. They were taught the benefits of exercise and behavioral strategies for success. They were also encouraged to lose the weight slowly.

The women in the HAES group received an early draft of this book and support in implementing the HAES program. Initial meetings focused on enhancing body acceptance and self-acceptance and on leading as full a life as possible, regardless of weight. The goal here was to first help the women disconnect their feelings of self-worth from their weight before we jumped into talking about food, activity, or other lifestyle choices.

An experienced registered dietician led the diet group while I led the HAES group. Each group gave us equally high marks in terms of enthusiasm, knowledge, and leadership ability, suggesting that the qualities of the group leader didn’t affect the research results.

The Final Results

And the results? (Drum roll please. . . .)

The HAES program won hands down, showing phenomenally better results than the conventional diet. Among the many great outcomes, these women no longer struggled with food issues. They’d moved from dieting (restrained eating) to intuitive eating (unrestrained eating), free to eat what they wanted, when they wanted.

The dieters? They remained restrained eaters. Which, of course, is just what diets teach us to do.

But what about the health effects?

The dieters didn’t fare very well. Although they showed some initial weight loss and health improvements, they didn’t sustain those health benefits—or the weight loss. Yup, back to the same size. A year of deprivation and watching themselves for nothing.

Unlike the dieters, however, the HAES women were flying high. They showed significant declines in levels of so-called “bad” LDL cholesterol and blood pressure. They almost quadrupled the amount of energy they spent being active and told us they felt more vital and enjoyed their bodies more.

Our HAES participants also showed noteworthy improvements in their body image and self-esteem. Here’s what some HAES participants told us:

Food sure tastes good now! I remember before I started the program: Thinking about what to eat terrified me and was always on my mind. Now it’s simple and fun.

Every morning I used to get on the scale. Whether I was up or down, it didn’t matter
—
the number always told me I wasn’t good enough. While in the program, I took the advice to change my scale, putting affirmations where the numbers once were. Now, the scale tells me I’m “perfect,” “sexy,” or “looking good!” And seeing that actually helps me eat better!

Who would have thought that I’d ever have broccoli cravings? And chocolate tastes better than ever now that I eat it guilt-free!

I never thought I’d ever enjoy exercising. But now a group of us meet at the basketball courts every Thursday night. Sure, it’s probably more socializing and laughing than playing basketball, but I look forward to it every time. And when I come home, I sure am tired.

I use to blame the fact that I had a four-year-old on my lack of time to exercise. But now the two of us blast the music and dance wildly
—
I don’t know which of us enjoys it more!

There’s a bathroom just a few doors down from my office. But now I make it a practice to take the stairs to a bathroom a few flights away. I actually look forward to the time walking there
—
my time
—
and I always come back to work feeling more energized. Sure it takes a few more minutes, but I’m also sure I more than make up for it in increased productivity.

My boss and I have walking meetings now. It’s so much more fun than hanging out in our offices. And I feel like I know her so much better now. It’s as if doing something together creates intimacy.

I went for a checkup recently and got the typical weight-loss lecture. When I interrupted to tell my doctor how proud I was of my glucose and LDL improving, he said, “All well and good, but what are we going to do about your weight?” “We’re going to fire you, Doc, that’s what we’re going to do!” I can’t believe how freeing it felt to say that!

Sadly, all these variables that improved in the HAES group (blood pressure, LDL, activity level, depression . . . ) either stayed the same or worsened in the dieting group.

Even more important: Almost half the dieters dropped out of the study (compared to less than 8 percent of the HAES women)—proof again that no one wants to stay on a diet.

And here’s the final nail in the dieting coffin: The dieters’ self-esteem plummeted while the HAES women grew more empowered. It didn’t surprise me: Happier, healthier people feel more empowered and make better choices.

We could see this coming. At the midpoint of the intervention, in response to the statement “The program has helped me feel better about myself,” 93 percent of the HAES group indicated “agree” or “strongly agree” compared with only 51 percent of the diet group.

The Weight-Loss Disclaimer

I can hear you now:
But did the HAES women lose weight
? The answer is no—at least not enough to be considered scientifically significant. But neither did the dieting women. Well, they did at first, but then they gained it all back. Which makes them less well off in the long run than if they’d never lost the weight in the first place! Plus, of course, these women’s existing feelings of failure and self-blame simply got worse.

But
, you’re probably thinking,
why bother if the HAES group didn’t lose weight?
Because what’s really important here, as I’ve tried to show you throughout this book, isn’t some nebulous number on the scale; it’s coming to the same conclusions the HAES women arrived at: that weight loss just isn’t as important as they thought.

These women discovered that their focus on weight loss had hidden their real quest: a desire to feel better about themselves, to have more vitality and good health, to feel attractive
for themselves,
not for anyone else. Once they dropped the weight-loss focus, that’s exactly what they got.

I’m sure it’s crossed your mind: If the women were eating better and exercising more, shouldn’t they have lost weight? Isn’t this the “magic formula” for weight loss? If you still think that, go back and reread chapter 1. Our bodies are invested in maintaining fat (weight) for “lean” times. They are just not very good at giving up that weight.

So even though some people can do pretty well at short-term weight loss by reducing their calories relative to the amount of energy they spend, maintaining that weight loss over the long term is the tricky part. Ergo, the dismal statistics on long-term weight loss, even when people persist in their diet and exercise programs, as discussed earlier. Even the most optimistic scientists acknowledge that the majority of dieters will regain the weight. Remember leptin’s double role? That it’s much more aggressive at preventing weight loss, but fairly laid back as your weight ratchets up? That’s why these women, for all their healthier habits, still didn’t lose weight.

Of course, they
might
lose weight over the long term as the work they did in HAES becomes more ingrained in their lives. We just don’t know, given the difficulty and expense of conducting that type of long-term study. In my opinion, what’s most important is that these women got healthier and felt better about themselves and their lives.

If you want a weight-loss book, take this book back to the bookstore and get your money back. This isn’t it. But if you want a plan that helps you feel better about yourself, physically and emotionally, improves your overall health, and provides you with the tools you need to maintain the weight that is right for your body, then you’ve come to the right place.

The next chapters will provide you with the Health at Every Size program.

Chapter 8 helps you enjoy your body.

You’ll learn how to look in the mirror and love, really love, what you see there, hips, stomach, thighs, and all. You’ll learn to accept yourself
as you are,
regardless of what your family, friends, or society say you
should be.
Just imagine how this kind of thinking can change your life.

Chapter 8 also gives you some survival tips to challenge the self-acceptance-damaging and setpoint-raising environment of our current culture that tries to undermine your efforts to live a healthy life without focusing on weight.

Chapter 9 helps you listen to your body, supporting you in eating for pleasure and nourishment.

At my son’s birthday party, a mom asked me for advice that would help her seven-year-old son, a binge eater, develop healthier eating habits. Moments later, her son joined us.

“I want another piece of cake,” he said. This request came shortly after eating a large meal and while he was still finishing up the remnants of his first piece.

“Why do you think you want it?” I asked.

He looked at me, surprised. “What do you mean? Because it tastes so good!”

“How did you feel when you ate the first piece?” I pushed.

Again, the confused stare. “I felt good, I felt happy.”

“So what you
really
want is to feel happy?” I asked.

“Is this a trick? Are you trying to say I can’t have another piece?”

“Nope, it’s all yours if you want it,” I said, cutting a piece to show I really meant it. “I’m just trying to help you figure out if you really want it.”

He looked pensive for a moment and then said, in a rather surprised voice, “Maybe I’d rather play on the trampoline.”

Fully engaged in play the rest of the afternoon, I’m not sure he thought about food.

BOOK: Health At Every Size: The Surprising Truth About Your Weight

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